What is Gout?


Gout is a painful joint ailment that most usually affects the big toe’s first metatarsophalangeal joint (the large joint at the base of the big toe). Gout is caused by a buildup of uric acid in the bloodstream. Hyperuricemia refers to a high level of uric acid in the blood. Small crystals (monosodium urate) form within joints and surrounding soft tissues as uric acid levels rise.

Gout is linked to a diet high in red meat and alcohol, as well as obesity and kidney failure. Gout is nine times more common in males than in women, and rheumatoid arthritis is nine times more common in men than in women. Gout becomes increasingly common as people get older.

What are some of the signs and symptoms of gout?
Gout attacks can strike without warning and are not usually accompanied by a stressful experience. Gout symptoms include:

  • Sudden onset of considerable pain in the big toe’s first metatarsophalangeal joint.
  • The first metatarsophalangeal joint is red, heated, and swollen.
  • Touching the damaged joint causes severe agony (even attempting to put your socks on can cause high levels of pain).
  • The big toe hurts when you move it.
  • Walking causes pain.

What other conditions can manifest themselves in the same way as gout?

  • Biig toe osteoarthritis.
  • Morton’s neuroma 
  • Osteoarthritis in the middle of the foot

Gout vs big toe osteoarthritis

The big toe is swollen and painful in both gout and osteoarthritis. Gout, on the other hand, is frequently associated with redness and heat. The big toe osteoarthritis usually advances slowly. It usually begins as recurrent episodes of pain that subside on their own. Osteoarthritis of the big toe is significantly more common in people over the age of 50, and it can affect both men and women. Gout, on the other hand, has a rapid start and can affect people of all ages. Gout patients frequently report having no previous toe pain. The toe returns to its usual size and shape when a gout episode has passed, and complete range of motion is restored. This is not the case with big toe osteoarthritis, which causes the toe to stiffen with time.

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What exactly is gout?

Gout is a very prevalent condition that affects 1.4 percent of the population. It is three times as common as rheumatoid arthritis.
Gout develops when the body creates excessive amounts of uric acid (urate) as a result of a condition known as hyperuricemia. Urate monosodium crystals develop and accumulate in soft tissues as a result of this. Gout is the outcome of this process.

When serum urate concentrations exceed 8.0mg/d, an attack of gout occurs. L. Tausche and colleagues (2009)


What causes gout?
Gout is a type of rheumatoid arthritis that affects the entire body. Although little is known about the actual origin of gout, there are numerous risk factors. These are some of them:

  • Gender. Gout is up to 9 times more common in men. The hormone oestrogen protects premenopausal women from gout.
  • Purine-rich foods such as red meat, wild game (Veal and dark) and offal are recommended.
  • An excessive amount of alcohol is consumed (both beer and wine have been implicated)
  • Getting older
  • Obesity
  • Failure of the kidneys
  • Thiazide, for example, is a prescription drug.
  • Hereditary uric acid disorder, on the other hand, is quite uncommon.

A sudden increase in rich foods or the consumption of alcohol can cause a Gout attack. A typical attack begins with severe pain in a single joint (often the big toe). Gout will usually go away on its own after a week. Unfortunately, if you have a Gout attack, you have a 90% probability of having another attack within the next five years.

How is gout diagnosed?
Gout is normally diagnosed by your doctor, who will ask you a number of questions in order to figure out what’s causing the attack (such as a big night out or a change in diet). Your doctor will order blood tests to determine the level of urate in your blood. Because serum levels often remain steady during an attack, the most precise urate serum levels are usually measured 2 to 3 weeks following the incident.

Gout can be diagnosed with diagnostic musculoskeletal ultrasonography, which has been proved to be a safe and effective method. It’s been demonstrated to be quite good at detecting bony erosions produced by inflammatory arthritic disorders like gout (Fernandez at et. 2017 and Villaverde et al. 2014).
All of our specialists at Joint Injections are thoroughly qualified musculoskeletal sonographers with extensive experience in evaluating this issue.

 How is gout treated?

The goal of immediate treatment is to alleviate the severe discomfort associated with a Gout attack. Your doctor will probably prescribe you a nonsteroidal anti-inflammatory drug like Naproxen, along with a gastric protector like Omeprazole.

If you have Gout on a regular basis, your doctor may prescribe Allopurinol, a long-acting urate-lowering medicine.


Long-term management necessitates a change in lifestyle. A good diet, moderate alcohol consumption, and weight loss will significantly minimise the risk of future Gout attacks.
Ultrasound guided injection
During an acute bout of Gout, an ultrasound-guided steroid injection can be utilised to relieve pain and inflammation. A corticosteroid is a strong anti-inflammatory that can be injected into the afflicted joint. Ultrasound imaging can be utilised to locate and guide the drug placement right at the Gout’s epicentre. Ultrasound-guided steroid injections are more efficacious and precise than landmarked injections, according to existing research.

All of our specialists at Joint Injections are extremely skilled musculoskeletal sonographers who can administer guided injections. With all ultrasound-guided injections, Joint Injections offers a same-day service. You do not need a referral from your doctor. In the same session, all of our clinicians can fully examine you, perform a diagnostic ultrasound scan, prescribe, and administer an injection.

Joint Injection’s experts are dual-trained, highly specialised physiotherapists and musculoskeletal sonographers with extensive experience diagnosing all foot and ankle. We provide a ‘one-stop’ clinic, which means you’ll get an examination, a diagnostic ultrasound, and, if necessary, an ultrasound-guided injection.